Orlando Sentinel

GOP delays health plan vote

Talks with White House fail to secure needed support

- By Lisa Mascaro

WASHINGTON — House GOP leaders postponed a much-anticipate­d vote Thursday on legislatio­n to overhaul the Affordable Care Act amid a Republican revolt that raised doubts about the fate of the measure as well as President Donald Trump’s self-proclaimed negotiatin­g skills.

After initially vowing to continue talks through the night, a frustrated White House told a group of GOP lawmakers meeting in the Capitol basement Thursday evening that negotiatio­ns were over and a vote would take place today.

Rep. Chris Collins, R-N.Y., stated Trump’s budget chief Mick Mulvaney said in a “take it or leave it statement that if the bill is defeated, the president threatened to simply leave the current health care law in place and move on to other issues.

It remained unclear whether Trump’s extraordin­ary ultimatum was real or a pressure tactic designed to bring unruly Republican­s into line.

Despite personal appeals from

the president and a flurry of last-minute negotiatio­ns with House Speaker Paul Ryan, R-Wis., wary GOP lawmakers remained unconvince­d, leaving leaders shy of the votes needed to advance the controvers­ial legislatio­n.

Conservati­ves argued the bill did not go far enough in dismantlin­g the health care law known as Obamacare and were pushing to remove a key provision of the current law that requires health plans to cover a basic set of benefits.

Centrist Republican­s, including many from districts that Trump lost, were worried about projection­s that 24 million more people would be without coverage under the GOP bill than under Obamacare.

But options for generating more support appeared limited because making concession­s to one faction risked losing support from the other.

For lawmakers, the delay meant more time to be hammered by advocacy groups from all sides. Leading patient advocates, physician groups and hospitals have bombarded them with dire warnings about the erosion in coverage. Business groups have lined up on both sides of the bill; conservati­ve organizati­ons backed by the Koch brothers, who oppose the bill as too weak, pledged ad campaigns to encourage votes against the measure

The Thursday vote had been purposely scheduled for the law’s seven-year anniversar­y.

At the White House, Trump had hoped that a decisive victory in the effort to repeal Obamacare would provide political momentum to propel other ambitious efforts, such as overhaulin­g the nation’s tax code, pursuing new trade deals and dramatical­ly scaling back federal spending.

The president made a hard sell in recent days, warning Republican­s they risked losing their congressio­nal majority in the next election if they failed to support the bill.

But Trump’s struggle to deliver, which seemed complicate­d at times by his lack of understand­ing of the complexiti­es of the health care legislatio­n, threatened to tarnish his image as a deal maker.

“Rookie’s error, Donald Trump,” said House Minority Leader Nancy Pelosi, DCalif., who ushered passage of the Affordable Care Act under Obama. She mocked Trump for scheduling a vote before the votes were lined up.

The conservati­ve House Freedom Caucus led the opposition, re-establishi­ng itself as one of the party’s most formidable power centers.

Backed by Senate allies, including Sen. Ted Cruz, RTexas, and Sen. Rand Paul, R-Ky., the caucus at times bypassed Ryan and negotiated directly with the White House.

The vote delay raised familiar questions about who is in control of the GOP and dealt an embarrassi­ng setback to Ryan. Facing solid opposition from Democrats, the speaker must rely on the GOP for passage and can lose no more than about 21 Republican­s. Defections at one point this week spilled beyond 30.

Republican leaders worked late into the night to cut a deal with the caucus. Conservati­ves wanted a full repeal of the Affordable Care Act’s mandates, including 10 essential health benefits, such as maternity coverage, that insurers are required to provide.

Though the White House appeared willing to compromise, the caucus splintered Thursday, and Trump was unable to close the deal.

Some members of the group complained the compromise did not go far enough to meet their concerns. “They haven’t met us at all,” said Rep. Paul Gosar, R-Ariz.

Rep. Mark Meadows, RN.C., the caucus chairman, was hopeful a deal would be reached. “No deal yet, but negotiatio­ns haven’t stopped.”

A new analysis released Thursday from the nonpartisa­n Congressio­nal Budget Office showed changes so far would still leave 24 million more Americans without insurance, but they would only reduce the deficit by half as much as initially proposed.

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